Objective: This meta-analysis aims to assess the effect of NIBS technique for psychiatric symptoms in patients with PD.

Background: Non-invasive brain stimulations (NIBS), especially repetitive transcranial magnetic stimulation (rTMS), are promising therapeutic tools for the psychiatric symptoms of Parkinson’s disease (PD).

Method: Several electronic databases were systematically searched for records from inception to Oct 18, 2021. The therapeutic effects of NIBS were evaluated by random-effects meta-analysis based on the standard mean difference (SMD) and effect estimates. Subgroup analyses, publication bias and sensitivity analyses were used to explore sources of heterogeneity.

Results: Finally, 57 and 15 studies with 4,010 participants of 13,639 papers were involved in the meta-analyses and systematic review, respectively. Significant differences were found between the NIBS and sham-stimulation/placebo participants for depression (SMD = -0.75, 95% CI: -0.99 to -0.50, I² = 79%), the rTMS combined with antidepressant therapy and antidepressant alone for depression (SMD = -0.98, 95% CI: -1.37 to -0.59, I² = 87%) and anxiety (SMD = -1.46, 95% CI: -2.44 to -0.48, I² = 95%). Meanwhile, lower risks were discovered for post-treatment compared with pre-treatment for depression (RR [relative risk] = 0.66, 95% CI: 0.57 to 0.76, I² = 96%) and anxiety (RR= 0.66, 95% CI: 0.60 to 0.73, I² = 67%).

Conclusion: NIBS, can be regarded as an effective non-pharmacological option to treat PD depression. rTMS combined with antidepressants are demonstrated a useful tool against depression and anxiety in PD. Advanced studies are required to further investigation the optimal NIBS protocols of psychiatric symptoms for PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/non-invasive-brain-stimulation-for-the-treatment-of-psychiatric-symptoms-in-parkinsons-disease-a-systematic-review-and-meta-analysis/